A 28-year-old male with no past medical history presents to the emergency department with two days of gradually worsening right index finger pain and swelling. The patient reports that he works on a saltwater fishing boat and frequently has cuts on his hand. A few days ago, he noticed worsening pain and swelling to a cut on his right index finger. Today, the pain worsened and he is having difficulty bending his finger. He states that the pain radiates from his index finger up his hand and right forearm. He has not had any fevers and there is no associated numbness or tingling…
Read MoreYou’re seeing a patient in the community emergency department with a primary headache disorder. Based on your history & physical examination skills, you have considered and ruled out all dangerous secondary headache causes such as intracranial hemorrhage, sentinel bleed, meningoencephalitis, abscess, tumor, temporal arteritis, hypertensive encephalopathy, acute angle closure glaucoma, etc. With many classes of treatments available, providers have typically used some form of a ‘migraine cocktail’ including IV prochlorperazine, IV ketorolac, IV diphenhydramine, IV dexamethasone, and/or IV normal saline…
Read MoreThe patient is 70-year-old female presenting with an episode of loss of consciousness at home. While eating dinner with her husband, the patient stated, “I don’t feel well,” and subsequently lost consciousness for 15 seconds. Per her husband, she spontaneously returned to baseline and vomited once. The patient denied any preceding symptoms including chest pain, shortness of breath, dizziness, nausea. There was no seizure-like activity. She stated that this has occurred 5-6 times previously, but she has had unremarkable Holter monitoring…
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